Provider First Line Business Practice Location Address:
7859 EL CAJON BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LA MESA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91942-0602
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-724-6400
Provider Business Practice Location Address Fax Number:
619-724-6401
Provider Enumeration Date:
04/21/2023